Summary of Benefits

Page 6

Summary of Benefits Premiums and Benefits

SummaCare Medicare Topaz (HMO)

SummaCare Medicare Garnet 1 (HMO)

SummaCare Medicare Ruby (HMO) Northeast

Preventive Care – Our plan covers many preventive services, including: Abdominal aortic aneurysm screening, Alcohol misuse counseling, Annual wellness visit, Bone mass measurement, Breast cancer screening (mammogram), Cardiovascular disease (risk reduction), Cardiovascular disease testing, Cervical and vaginal cancer screening, Colorectal cancer screenings (Colonoscopy, Fecal occult blood test, Flexible sigmoidoscopy), Depression screening, Diabetes screening, HIV screening, Medical nutrition therapy services, Obesity screening and counseling, Prostate cancer and counseling, Sexually transmitted infections screening and counseling, Tobacco use cessation counseling (counseling for people with no sign of tobaccorelated disease), Vaccines, including Flu shots, Hepatitis B shots, Pneumococcal shots, “Welcome to Medicare” preventive visit (one-time)

You pay nothing.

You pay nothing.

You pay nothing.

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8/27/19 12:16 PM


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